Zanmi Agrikol, which translates to “Partners In Agriculture” in Creole, uses agricultural initiatives to both encourage local production of crops used in the treatment and prevention of pediatric malnutrition and to increase food security for families of malnourished children. Zanmi Agrikol has three main components: the local production of therapeutic foods (called Nourimanba and Nourimil) used to treat and prevent malnutrition; the operation of two farms and contracts with local farmers who grow crops (mainly peanuts) used to make these foods; and the Family Assistance Program, an agricultural assistance program for the poorest families, many of whom are identified because their children have been treated for malnutrition. Launched as a pilot program in one site, Boucan Carré, Zanmi Agrikol now encompasses all of Zanmi Lasante’s sites in the Central Plateau.
Through Zanmi Agrikol, Zanmi Lasante produces Nourimanba and Nourimil to meet the pressing need for effective and cost-efficient treatment for malnutrition, which affects a third of children living in Haiti. Producing these therapeutic foods locally means that we are creating jobs and contributing to the local economy. Nourimanba is a “Ready to Use Therapeutic Food” made from a peanut butter base combined with milk powder, vegetable oil, sugar and a specially formulated vitamin mix. It is used for severely malnourished children and has the advantage of being a home-based treatment: children are treated with Nourimanba in hospital for two weeks (in which parents and caregivers are trained in how to give the treatment) and then continue their treatment at home for another four weeks. Nourimil is made of beans and rice or corn and is used on an outpatient basis for moderately malnourished children to prevent further deterioration. In FY 2011, PIH and Zanmi Lasante anticipate treating approximately 6,000 malnourished children with Nourimanba and Nourimil.
Currently, Zanmi Lasante operates a small production center in Cange where local workers mix ingredients, produce, and package Nourimil and Nourimanba. To further reduce cost and stimulate the local economy, Zanmi Lasante operates two farms in the nearby village of Corporant and Lachteau, where 79 farmers are employed to grow corn and beans used for Nourimil. We also buy peanuts for Nourimanba from local farmers around Corporant. Zanmi Lasante provides initial seeds to these farmers (who return an equivalent amount of seeds at the end of the growing season) and pays a fair market price for their entire peanut crop. This arrangement provides the farmers with predictable revenue and in sufficient quantity to invest in new tools, land, and other inputs. Currently over 200 farmers are involved in growing peanuts for Zanmi Lasante. Plans are currently underway to complete the construction of a main depot in Corporant where the production of Nourimanba and Nourimil can be housed. In FY 2011, PIH and Zanmi Lasante will support 279 farmers to produce roughly 43,000 kilograms of Nourimanba and 184,600 lbs of Nourimil (based on last year’s production totals).
The third component of Zanmi Agrikol is the Family Assistance Program which helps extremely destitute families improve their basic household food supply in order to battle long-term food insecurity. Typically, Zanmi Lasante has enrolled families of children who are being treated for malnutrition at a Zanmi Lasante site. Each family is assigned an ajan agrikol – a local resident employed by Zanmi Lasante as an outreach worker – who works with each family to boost their household production of food. Practically, this means the ajan agrikol provides tools, seeds, training, and at least bi-weekly visits to families enrolled in the program. Each ajan agrikol is responsible for 10 families, visiting them weekly or every other week; there are 240 families who have been enrolled in the project over the past two years. Immediately following the earthquake, Zanmi Lasante hired 20 additional ajan agrikol (bringing the total to 42), and expanded the Family Assistance Program to meet the pressing needs of families, most of whom have taken on survivors from the earthquake who fled Port-au-Prince. We have also started the farm at Lachteau, mentioned above, which will have dedicated areas for demonstration and farming plots for families to practice new techniques and grow crops. Zanmi Lasante has identified 50 kombit (groups) of 20 families, meaning thatin FY 2011 the Family Assistance Program will now serve 1,240 families who are extremely food insecure.
Monitoring, Evaluation, and Key Partners
The project will be monitored and evaluated with the following indicators:
- Number of malnourished or at-risk children provided Nourimanba and Nourimil: target of 6,000 children
- Amount of Nourimanba/Nourimil produced: goal of 43,200 kilograms of Nourimanba and 184,600 lbs. of Nourimil
- Number of farmers employed to work on production farms: target of 79 (including both contract and permanent farmers)
- Number of local farming families who are provided with seeds, use of tractor, and guaranteed market price, in order to grow peanuts for Nourimanba: target of 200 families
- Number of families provided seeds, training, and support: target of 1,240 families
- Number of agricultural trainings held: target of all families participating in at least 2 trainings
Evaluation will be overseen by Marie Flore Chipps, coordinator of Zanmi Agrikol. The first indicator listed will be reported by the clinicians in the pediatric wards of Zanmi Lasante clinics. The remaining indicators will be monitored and reported by Zanmi Lasante’s three lead agronomists. Two Boston-based Haiti program managers and one Haiti-based nutrition coordinator will provide ongoing monitoring of program progress and assistance with budgeting and reporting to donors.
To further assess the impact of the project, in FY 2011 PIH and Zanmi Lasante are continuing our partnership with a local organization, Fonkoze, a local NGO that provides microcredit opportunities and has begun screening families in their program for malnutrition. Fonkoze trains their community agents to screen families for malnutrition and then refers them to Zanmi Lasante clinical sites, and also trains them in following up with these families after referral. Because increased screening will likely lead to greater identification of pediatric malnutrition and more need for treatment, Fonkoze is also working to find donations of additional RUTF for these families.